Autonomic and brain morphological predictors of stress resilience

Stressful life events are an important cause of psychopathology. Humans exposed to aversive or stressful experiences show considerable inter-individual heterogeneity in their responses. However, the majority does not develop stress-related psychiatric disorders. The dynamic processes encompassing positive and functional adaptation in the face of significant adversity have been broadly defined as resilience. Traditionally, the assessment of resilience has been confined to self-report measures, both within the general community and putative high-risk populations. Although this approach has value, it is highly susceptible to subjective bias and may not capture the dynamic nature of resilience, as underlying construct. Recognizing the obvious benefits of more objective measures of resilience, research in the field has just started investigating the predictive value of several potential biological markers. This review provides an overview of theoretical views and empirical evidence suggesting that individual differences in heart rate variability (HRV), a surrogate index of resting cardiac vagal outflow, may underlie different levels of resilience toward the development of stress-related psychiatric disorders. Following this line of thought, recent studies describing associations between regional brain morphometric characteristics and resting state vagally-mediated HRV are summarized. Existing studies suggest that the structural morphology of the anterior cingulated cortex (ACC), particularly its cortical thickness, is implicated in the expression of individual differences in HRV. These findings are discussed in light of emerging structural neuroimaging research, linking morphological characteristics of the ACC to psychological traits ascribed to a high-resilient profile and abnormal structural integrity of the ACC to the psychophysiological expression of stress-related mental health consequences. We conclude that a multidisciplinary approach integrating brain structural imaging with HRV monitoring could offer novel perspectives about brain-body pathways in resilience and adaptation to psychological stres

Study protocol; thyroid hormone replacement for untreated older adults with subclinical hypothyroidism - a randomised placebo controlled trial (TRUST)

Background: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. Methods: Participants are community-dwelling subjects aged ≥65 years with SCH, diagnosed by elevated TSH levels (≥4.6 and ≤19.9 mU/L) on a minimum of two measures ≥ three months apart, with fT4 levels within laboratory reference range. The study is a randomised double-blind placebo-controlled parallel group trial, starting with levothyroxine 50 micrograms daily (25 micrograms in subjects <50Kg body weight or known coronary heart disease) with titration of dose in the active treatment group according to TSH level, and a mock titration in the placebo group. The primary outcomes are changes in two domains (hypothyroid symptoms and fatigue / vitality) on the thyroid-related quality of life questionnaire (ThyPRO) at one year. The study has 80% power (at p = 0.025, 2-tailed) to detect a change with levothyroxine treatment of 3.0% on the hypothyroid scale and 4.1% on the fatigue / vitality scale with a total target sample size of 750 patients. Secondary outcomes include general health-related quality of life (EuroQol), fatal and non-fatal cardiovascular events, handgrip strength, executive cognitive function (Letter Digit Coding Test), basic and instrumental activities of daily living, haemoglobin, blood pressure, weight, body mass index and waist circumference. Patients are monitored for specific adverse events of interest including incident atrial fibrillation, heart failure and bone fracture. Discussion: This large multicentre RCT of levothyroxine treatment of subclinical hypothyroidism is powered to detect clinically relevant change in symptoms / quality of life and is likely to be highly influential in guiding treatment of this common condition. Trial registration: Clinicaltrials.gov NCT01660126; registered 8th June 2012

An Application of Bayesian Network in Cognitive Behavioral Therapy

Mental health has received increased focus in recent years, with a larger emphasis on treatment and acceptance. However, evidence-based psychological interventions are of poor availability and have room for improvement. The amount of data being gathered across applications and practices provide opportunities for deeper analysis through machine learning based technologies. By applying Bayesian networks (BNs) in a cognitive behavioral therapy for adults with ADHD, this research analyzes historic self-report data to predict the behavior of future participants at an early stage of the online intervention. Bayesian networks represent probabilistic models that describe the joint probability distribution through an acyclic graph. The contribution of this thesis is an artifact with the purpose of serving as a decision making support tool. Methods of Design Science Research was applied to achieve this, in a development cycle with three main iterations. Using Bayesian networks for analyzing behavioral patterns yield positive results with its predictive capabilities when dealing with uncertainty. Domain experts from the internet-delivered intervention provided useful feedback and insight that contributed to the novelty and research scope of this thesis. Future work should update the model when a larger population sample is available, and focus on implementing the artifact in a more user-centered desktop application.Masteroppgave i informasjonsvitenskapINFO390MASV-INF

Annual volume increment of the European forests—description and evaluation of the national methods used

International audienceAbstractKey messageIn order to obtain the necessary information for decision making etc., it is of increasing importance to be able to assess increment in a reliable way. Only repeated measurements on permanent sample plots in national forest inventories can provide accurate and comprehensive information on the various components of annual increment. Such inventory systems are increasingly employed in European countries. The felling/increment ratio, characterizing wood use sustainability, should be expressed as the ratio of felled living trees (excluding dead trees) and net increment.ContextReporting of gross and net annual increment is an element of international forest resource assessments and crucial for sustainable forest management. A number of approaches exist for the estimation of increment and its various sub-components. AimsThe main objectives of the study are to assess in detail what methods European countries have used and are planning to use in the future for international reporting of increment. Also, the usefulness of the various approaches for the assessment of increment is evaluated.MethodsA questionnaire asking about their assessment methods was distributed among the UNECE/FAO national correspondents of all European countries and members of the UNECE/FAO Team of Specialists on Monitoring Sustainable Forest Management. Databases of the Temperate and Boreal Forest Resource Assessment 2000 and of the State of Europe’s Forests 2011 were also used. Furthermore, the methodological background was described on the basis of relevant literature sources and some examples for country groups presented.ResultsCountries have indicated what methods they used for assessment of various increment components, and the percentage of countries, forest area, and growing stock corresponding to these replies has been calculated. With regard to gross annual increment, these metrics represent about one third for inventories based on permanent sample plots, but this percentage is on the increase.ConclusionThe concept of the “control method” for forest management was developed more than 100 years ago but only utilized at the local level. The same methodology is now widely used at the national and regional level due to the implementation of modern national forest inventories using permanent sample plots. Care should be taken to utilize the data correctly for international forest resource assessments, in order to, e.g., avoid double counting of dead trees

Bayesian latent time joint mixed-effects model of progression in the Alzheimer's Disease Neuroimaging Initiative.

IntroductionWe characterize long-term disease dynamics from cognitively healthy to dementia using data from the Alzheimer's Disease Neuroimaging Initiative.MethodsWe apply a latent time joint mixed-effects model to 16 cognitive, functional, biomarker, and imaging outcomes in Alzheimer's Disease Neuroimaging Initiative. Markov chain Monte Carlo methods are used for estimation and inference.ResultsWe find good concordance between latent time and diagnosis. Change in amyloid positron emission tomography shows a moderate correlation with change in cerebrospinal fluid tau (ρ = 0.310) and phosphorylated tau (ρ = 0.294) and weaker correlation with amyloid-β 42 (ρ = 0.176). In comparison to amyloid positron emission tomography, change in volumetric magnetic resonance imaging summaries is more strongly correlated with cognitive measures (e.g., ρ = 0.731 for ventricles and Alzheimer's Disease Assessment Scale). The average disease trends are consistent with the amyloid cascade hypothesis.DiscussionThe latent time joint mixed-effects model can (1) uncover long-term disease trends; (2) estimate the sequence of pathological abnormalities; and (3) provide subject-specific prognostic estimates of the time until onset of symptoms

Optical coherence tomography in Alzheimer's disease. A meta-analysis

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder, which is likely to start as mild cognitive impairment (MCI) several years before the its full-blown clinical manifestation. Optical coherence tomography (OCT) has been used to detect a loss in peripapillary retina nerve fiber layer (RNFL) and a reduction in macular thickness and volume of people affected by MCI or AD. Here, we performed an aggregate meta-analysis combining results from different studies. METHODS AND FINDINGS: Data sources were case-control studies published between January 2001 and August 2014 (identified through PubMed and Google Scholar databases) that examined the RNFL thickness by means of OCT in AD and MCI patients compared with cognitively healthy controls. RESULTS: 11 studies were identified, including 380 patients with AD, 68 with MCI and 293 healthy controls (HC). The studies suggest that the mean RNFL thickness is reduced in MCI (weighted mean differences in μm, WMD = -13.39, 95% CI: -17.34 to -9.45, p = 0.031) and, even more so, in AD (WMD = -15.95, 95% CI: -21.65 to -10.21, p<0.0001) patients compared to HC. RNFL in the 4 quadrants were all significantly thinner in AD superior (superior WMD = -24.0, 95% CI: -34.9 to -13.1, p<0.0001; inferior WMD = -20.8, 95% CI: -32.0 to -9.7, p<0.0001; nasal WMD = -14.7, 95% CI: -23.9 to -5.5, p<0.0001; and temporal WMD = -10.7, 95% CI: -19.9 to -1.4, p<0.0001); the same significant reduction in quadrant RNFL was observed in MCI patients compared with HC (Inferior WMD = -20.22, 95% CI: -30.41 to -10.03, p = 0.0001; nasal WMD = -7.4, 95% CI: -10.08 to -4.7, p = 0.0000; and temporal WMD = -6.88, 95% CI: -12.62 to -1.13, p = 0.01), with the exception of superior quadrant (WMD = -19.45, 95% CI: -40.23 to 1.32, p = 0.06). CONCLUSION: Results from the meta-analysis support the important role of OCT for RNFL analysis in monitoring the progression of AD and in assessing the effectiveness of purported AD treatments

INVESTIGATING THE RELATION BETWEEN COMMON CAUSE COUPLING FACTORS AND AGEING

Usually, probabilistic safety analyses are using the assumption of the constant component failure rate, and the assumption that the probability associated to common cause failure (CCF) will be constant in time. Still, as ageing phenomena could have some influence on components or systems performances, is probable that it could influence the probability of occurrence of CCFs also. This paper is devoted to investigation of the most important CCFs initiating factors from point of view of relation to ageing phenomena. The connections between CCF potential and ageing phenomena, as the influence of the individual prevention factors against CCF were evaluated. A questionnaire has been developed on this topic and all the inputs provided were summarized, compared and commented. The analysis has not been limited only to the list of negative factors that would increase the CCF potential, it has included also positive factors representing the prevention and correction measures applied with the aim to avoid occurrence and recurrence of CCF events, whether related to ageing or not. Two main topics were discussed: a) the strength of relation between the individual CCF coupling factors (contributing to total CCF potential) and ageing phenomena; b) the effect of CCF prevention measures on the coupling factors versus ageing relation (estimated for those CCF coupling factors that were evaluated as coincident with ageing phenomena, with at least medium level of coincidence).JRC.F.5-Nuclear Reactor Safety Assessmen